Chronic subdural hematoma (CSDH) is one of the most common types of intracranial hemorrhage, particularly in elderly individuals. Although most patients present with unilateral CSDH, bilateral involvement is not rare. Furthermore, bilateral CSDHs are associated with rapid deterioration and poorer outcomes because of a higher risk of brain herniation than unilateral hematomas. The most contentious issue is the potential herniation of the medial temporal lobe, which remains on the unevacuated side during the brief interval between right and left procedures. We compared simultaneous burr-hole craniostomy with consecutive burr-hole craniostomy for treating bilateral CSDH and to determine whether consecutive evacuation is riskier in terms of brain stem complications.Over a 6.5-year period, patients with bilateral CSDH who had an indication for operation were allocated into two groups randomly. The first group (n = 18) underwent simultaneous evacuation, and the second group (n = 25) underwent consecutive evacuation. Glasgow Coma Scale and Markwalder grades were recorded during the postoperative period. Patients were followed up during the inpatient period and postoperatively at 1, 3, 6, and 12 months after discharge. Mortality, morbidity, surgical complications, reoperation, and, as a combination of all of these, treatment success rates were compared. Treatment success rates were worse in patients with mixed-density hematomas and in female patients at the end of 12 months, but there was no significant difference between the simultaneous and consecutive evacuation groups at any time. Therefore, the choice of technique can be decided by the surgeon.

Background and Objectives: The assessment of cervical lordosis is essential for surgical planning and outcome prediction in patients with cervical spine pathology. This study aims to evaluate the accuracy of cervical lordosis measurements obtained on supine CT and MRI relative to standing lateral radiographs. Materials and Methods: In this retrospective review, 108 patients who underwent standing lateral radiographs, supine CT, and MRI within a 30-day period were identified. C2–C7 Cobb angles were measured on each modality. Using upright radiographs as the reference standard, the predictive capability of both supine CT and supine MRI in classifying kyphotic versus non-kyphotic alignment was calculated. Results: Standing radiographs demonstrated significantly greater lordosis than supine imaging, with mean paired differences of 6.2° versus CT and 5.0° versus MRI (both p < 0.001); however, strong correlations were observed (with CT: r = 0.75; with MRI: r = 0.72; both p < 0.001). Further, CT-based measurements predicted X-ray Cobb angles with an R² value of 0.57 (estimated X-ray Cobb angle = 8.24 + 0.74 × (CT Cobb angle), β = 0.74, p < 0.001). MRI-based measurements yielded an R² of 0.51 (estimated X-ray Cobb angle = 7.59 + 0.71 × (MRI Cobb angle), β = 0.71, p < 0.001). At threshold ≥ 0°, CT achieved a 100% NPV for excluding kyphosis on upright radiographs. MRI achieved an NPV of 100% when the Cobb angle was >1.20°. Conclusions: Supine CT and MRI systematically underestimate cervical lordosis but demonstrate strong predictive correlation with standing radiographs and reliably exclude true kyphotic alignment, with each achieving near-perfect NPV at defined thresholds. In cases where standing radiographs are unavailable or nondiagnostic, supine imaging modalities such as CT and/or MRI, where the cervical region appears nonkyphotic, can safely rule out cervical kyphosis and inform surgical planning; however, in cases where the cervical region appears kyphotic on CT and/or MRI, standing radiographs remain essential for accurate assessment.

Dural grafts are sometimes necessary for repairing spinal dural defects. The search for an ideal material for duraplasty remains a controversial topic. Twenty-six adult male Wistar-Albino rats, weighing 260-380 g, were used. The rats were divided into three groups: Control (n=10), Fascia (n=6), and Gore-Tex (polytetrafluoroethylene) Surgical Membrane group (n=10). After laminectomy was performed on the rats, a dural defect was created. Then, one of the procedures 'leaving the defect open,' 'duraplasty with fascia,' and 'duraplasty with Gore-Tex surgical membrane' was performed. On the 60th day after surgery, the rats were euthanized, and histological investigations were conducted to examine the granulation tissue and adhesions in the operative area. It was observed that granulation tissue filled the defect area in all three groups. In the fascia group, it was observed that the fascia formed a barrier between the dura mater and neural tissue and the granulation tissue, but it was filled with dense granulation tissue and there was adhesion. It was found that the granulation tissue did not adhere to the Gore-Tex surgical membrane in the Gore-Tex surgical membrane group, and the Gore-Tex surgical membrane created an excellent physical barrier preventing adhesion between the dura mater and neural and the granulation tissues.

This study evaluates the contribution of Turkish authors to the main neurosurgical literature, with a focus on the leadership roles of Turkish neurosurgeons, by analyzing publications in the 10 most influential neurosurgery journals between 2015 and 2024. A total of 46,616 articles from the top neurosurgery journals-ranked by impact factor-were reviewed. Data on Turkish authorship, authorship position, specialty, article type, subspecialty, and affiliation were collected. Among the reviewed articles, 1226 (2.63%) included at least 1 Turkish author; 1033 (84.3%) involved at least 1 Turkish neurosurgeon. Turkish authors held first and last authorship in 68.2% and 68.6% of these articles, respectively, with both positions occupied in 58.7%. Most contributions were original research (69.4%). Subspecialty analysis showed strong representation in general neurosurgery, neurovascular, and spine, while functional and pediatric neurosurgery were underrepresented. While 62.5% of articles were produced solely in Turkey, 37.5% involved international institutions, most frequently from the United States and Germany. Turkish contribution varied significantly by journal (P < 0.001), but not by quartile (P = 0.328) or impact factor (P = 0.1600). Turkish neurosurgeons consistently contribute to the global neurosurgical literature, especially through original research and leadership roles. Enhancing interdisciplinary collaboration and increasing visibility in high-impact journals will be key to expanding the academic presence of Turkish neurosurgery.

OBJECTIVE: Decreasing intradiscal pressure has been reported to improve sciatica, caused by nerve root pressure in herniated discs and improve discogenic low back pain in some cases. Percutaneous laser disc decompression is among percutaneous methods to decrease the disc volume (nucleus pulposus). The authors aimed to present the effects of the percutaneous laser disc decompression on symptomatic patients with lumbar disc hernia. MATERIAL AND METHODS: The clinical assessments of the patients s with complaints of low back and/or leg pain due to L4-L5 disc herniation were performed using the Visual Analog Scale (VAS) and the Oswestry Disability Index (ODI) before percutaneous laser disc decompression. Early VAS values were recorded in the 2nd hour after surgery. Also, a clinical evaluation was performed using the ODI and VAS both 1 and 3 months after the procedure. The patients whose VAS values decreased by 2 points or more (out of 10) compared to the preoperative period were determined to have benefited from the procedure for these periods. For the long-term outcomes, ODI was used for at least 10 years of follow-up, and the triple Likert scale was used to evaluate patient satisfaction. RESULTS: Twenty-one L4-L5 percutaneous laser disc decompressions were performed in our clinic. The success rate of percutaneous laser disc decompression was determined to be 90.0% for the first three months based on the decrease in VAS values and 72.73% over a ten year period, according to the ODI. CONCLUSIONS: The success rates show that this procedure has achieved promising results for patients in both the short and long term. The advantages of this technique include the ease of use and its applicability as an outpatient procedure.